Dysmenorrhea · Cold with Blood Stasis Pattern

Updated: June 23, 2026
Reviewed by: Dr. Li Wei, DACM
Reading Time: 7 min
Body Area: Pelvis


Pattern Overview

Cold with Blood Stasis is a common pattern in dysmenorrhea, characterized by cold-induced uterine vasoconstriction, menstrual pain relieved by warmth, cold extremities, and dark menstrual blood with clots. The core pathogenesis is Cold invading the uterus causing Blood stasis, leading to uterine vasoconstriction, ischemia, and severe cramping pain.


Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
Primary SymptomsCramping menstrual pain, relieved by warmth, cold extremities
Associated SymptomsDark menstrual blood with clots, pale complexion, cold lower back
Tongue and PulsePale tongue with white coating, deep and tense pulse
PathogenesisCold invading the uterus causing Blood stasis
EtiologyCold food intake, cold exposure during menstruation, constitutional Cold

Acupuncture Point Prescription

PointLocationFunction
Guanyuan (RN4)3 cun below the umbilicusWarms the uterus and supplements Yuan Qi
Qihai (RN6)1.5 cun below the umbilicusTonifies Qi and warms the lower abdomen
Sanyinjiao (SP6)3 cun above the medial malleolusMaster point for gynecological conditions; regulates menstruation
Diji (SP8)3 cun above the medial malleolus, on the Spleen meridianXi-Cleft point of Spleen; treats acute menstrual pain
Shiqizhui (EX-B8)On the lower back, below the spinous process of L5Extra point for painful menstruation

Clinical Recommendation: Filament needle, even method; heavy moxibustion is strongly recommended to warm the uterus and disperse Cold.


Herbal Formula

Base Formula: Wen Jing Tang (温经汤) or Shao Fu Zhu Yu Tang (少腹逐瘀汤)

Composition (Shao Fu Zhu Yu Tang):
Fennel Seed (Xiao Hui Xiang), Dried Ginger (Gan Jiang), Myrrh (Mo Yao), Angelica (Dang Gui), Chuanxiong (Chuan Xiong), Cinnamon (Rou Gui), Trogopterus Dung (Wu Ling Zhi), Pollen Typhae (Pu Huang)

Action: Warms the uterus, disperses Cold, invigorates blood, and resolves stasis.

Modifications

Associated SymptomsAdditions/Subtractions
Severe cold painAdd Fu Zi, Gui Zhi to warm Yang and disperse Cold
Dark blood clotsAdd Tao Ren, Hong Hua to invigorate blood
Cold extremitiesAdd Gui Zhi, Sheng Jiang to warm the meridians
WeaknessAdd Huang Qi, Dang Shen to supplement Qi

Western Mechanism Reference

Cold-induced uterine artery vasoconstriction causing ischemia and hypoxia, with increased uterine artery resistance and decreased blood flow. Cold with Blood Stasis corresponds to dysmenorrhea with cold sensitivity, where cold-induced vasoconstriction and reduced uterine blood flow contribute to ischemia and pain.


References

  1. Gynecology of TCM - Dysmenorrhea with Cold Coagulation and Blood Stasis.
  2. Zang-Fu Pattern Differentiation: Cold Coagulation belongs to Excess Pattern - Clearing and Warming.
  3. WHO. (2023). Women’s health. World Health Organization.

Explore More

  • Find your solution at MendGod.com – Personalized herbal protocols and acupressure tools for menstrual health.
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